Organization
PILSEN DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NUHA MUSEITIF NAKIB (PERIODONTIST)
(773) 823-1924
Entity
Organization
Contact information
Practice address
2158 W CERMAK RD, CHICAGO, IL 60608-4040
(773) 823-1924
(773) 823-1674
Mailing address
2158 W CERMAK RD, CHICAGO, IL 60608-4040
(773) 823-1924
(773) 823-1674
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019028803
IL
1223P0300X
Periodontics
021001685
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002328
IL
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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